Medical cannulae, delivery systems and methods

ABSTRACT

The disclosure relates to cannulae, delivery systems, methods of making cannulae, and methods of making delivery systems. A delivery system comprises an elongate outer tubular member defining an outer tubular member lumen, a cannula having a circumferential wall extending between a proximal end and a distal end and defining an interior lumen, and an intraluminal medical device disposed within the outer tubular member lumen distal to the cannula and not about the cannula. A pattern of openings arranged in an interrupted spiral extends circumferentially along the cannula.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.15/140,028, filed on Apr. 27, 2016 and issued as U.S. Pat. No.10,327,933, which claims the benefit of U.S. Provisional PatentApplication No. 62/153,814, filed on Apr. 28, 2015. Each of theserelated applications is incorporated by reference into this disclosurein its entirety.

FIELD

The disclosure relates generally to the field of medical devices. Moreparticularly, the disclosure relates to the fields of cannulae, deliverysystems, and methods of making medical devices.

BACKGROUND

Delivery systems for implanting intraluminal medical devices at a pointof treatment within a body vessel require both pushability andflexibility. Development of delivery systems and delivery systemcomponents that provide these desirable characteristics continues.

BRIEF SUMMARY OF SELECTED EXAMPLES

Several cannulae are described and illustrated herein. An examplecannula comprises an elongate tubular member having a circumferentialwall extending between a proximal end and a distal end and defining aninterior lumen; a pattern of openings extends along a portion of theaxial length of the cannula.

Another example cannula comprises an elongate tubular member having acircumferential wall extending between a proximal end and a distal endand defining an interior lumen; a pattern of openings extends along theentire axial length of the cannula.

Another example cannula comprises an elongate tubular member having acircumferential wall extending between a proximal end and a distal endand defining an interior lumen; a pattern of openings extends along anintermediate portion of the axial length of the cannula that is disposedbetween proximal and distal portions of the cannula that are free of thepattern of openings.

Another example cannula comprises an elongate tubular member having acircumferential wall extending between a proximal end and a distal endand defining an interior lumen; a pattern of openings extends along anintermediate portion of the axial length of the cannula that is disposedbetween proximal and distal portions of the cannula that are free of thepattern of openings; the proximal portion is longer than the distalportion.

Several delivery systems are described and illustrated herein. Anexample delivery system comprises a cannula comprising an elongatetubular member having a circumferential wall extending between aproximal end and a distal end and defining an interior lumen; a patternof openings extending along an intermediate portion of the axial lengthof the cannula that is disposed between proximal and distal portions ofthe cannula that are free of the pattern of openings; the proximalportion is longer than the distal portion; an intraluminal medicaldevice disposed on the distal portion of the cannula; and an elongateouter tubular member defining an outer tubular member lumen. The cannulais disposed within the outer tubular member lumen such that theintraluminal medical device is circumferentially disposed about thecannula and within the outer tubular member lumen.

Several methods of making a cannula are described and illustratedherein. An example method of making a cannula comprises identifying acannula material and a cannula wall thickness that provides a desiredglobal stiffness for said cannula; identifying one or more axial lengthsof said cannula along which a localized stiffness, different from thedesired global stiffness, is desired; identifying a pattern of openingsthat will provide the desired localized stiffness when cut into acannula formed of the cannula material and having the cannula wallthickness; and cutting the pattern of openings into a cannula formed ofthe cannula material and having the cannula wall thickness at axialpositions that correspond to the one or more axial lengths.

Several methods of making a delivery system are described andillustrated herein. An example method of making a delivery systemcomprises identifying a cannula material and a cannula wall thicknessthat provides a desired global stiffness for said cannula; identifyingone or more axial lengths of said cannula along which a localizedstiffness, different from the desired global stiffness, is desired;identifying a pattern of openings that will provide the desiredlocalized stiffness when cut into a cannula formed of the cannulamaterial and having the cannula wall thickness; cutting the pattern ofopenings into a cannula formed of the cannula material and having thecannula wall thickness at axial positions that correspond to the one ormore axial lengths; disposing an intraluminal medical device on aportion of the cannula that is free of the pattern of openings; andinserting the cannula into an elongate tubular member defining a lumensuch that the intraluminal medical device is circumferentially disposedabout the cannula and within the lumen.

Additional understanding of the inventive cannulae, delivery systems andmethods can be obtained by reviewing the description of selectedexamples, below, with reference to the appended drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of an example cannula.

FIG. 2 is a magnified view of area I in FIG. 1 .

FIG. 3 is a magnified sectional view of the example cannula illustratedin FIG. 1 , taken along line 3-3.

FIG. 4A is a magnified view of a portion of an alternative cannula.

FIG. 4B is a magnified view of a portion of another alternative cannula.

FIG. 4C is a magnified view of a portion of another alternative cannula.

FIG. 5 is a magnified view of a portion of another example cannula.

FIG. 6 is a side view, partially broken away, of another examplecannula.

FIG. 7 is a side view, partially broken away, of another examplecannula.

FIG. 8 is a side view, partially broken away, of another examplecannula.

FIG. 9 is a perspective view of another example cannula.

FIG. 10 is a magnified view of area I in FIG. 9 .

FIG. 11 is a schematic view of a transverse sectional view of thecannula illustrated in FIG. 9 , taking within area I.

FIG. 12A is a magnified view of another example cannula.

FIG. 12B is a magnified view of another example cannula.

FIG. 12C is a magnified view of another example cannula.

FIG. 13 is a side view, partially broken away, of another examplecannula.

FIG. 14 is a magnified view of another example cannula.

FIG. 15 is a transverse cross-sectional view of the cannula illustratedin FIG. 14 .

FIG. 16 is an exploded view of an example delivery system.

FIG. 17 is an exploded view of another example delivery system.

FIG. 18 is an exploded view of another example delivery system.

FIG. 19 is an exploded view of another example delivery system.

FIG. 20 is a flowchart representation of an example method of making acannula.

FIG. 21 is a flowchart representation of an example method of making acannula.

FIG. 22 is a schematic representation of a transformation of matter thatoccurs with performance of the method illustrated in FIG. 21 .

FIG. 23 is a flowchart representation of an example method of making adelivery system.

DETAILED DESCRIPTION OF SELECTED EXAMPLES

The following detailed description and appended drawings describe andillustrate various examples contemplated by the inventors. Thedescription and drawings serve to enable one skilled in the art to makeand use the inventive cannulae and delivery systems, and to practice theinventive methods; they are not intended to limit the scope of theinvention or the protection sought in any manner. The invention iscapable of being practiced or carried out in various ways; the examplesdescribed herein are merely selected examples of these various ways andare not exhaustive. As such, the language used in the description is tobe given the broadest possible scope and meaning.

Unless otherwise defined herein, scientific and technical terms used inconnection with the invention shall have the meanings that are commonlyunderstood by those of ordinary skill in the art. Further, unlessotherwise required by context, singular terms shall include pluralitiesand plural terms shall include the singular.

As used herein, the term “opening” refers to a passage defined by amember between opposing or substantially opposing surfaces of themember. The term does not require any particular configuration of thepassage. Indeed, the term includes rectangular passages, generallyrectangular passages, square passages, generally square passages,circular passages, generally circular passages, triangular passages,generally triangular passages, and irregular passages.

As used herein, the term “slit” refers to an opening that has arectangular or generally rectangular shape when the surfaces betweenwhich the passage extends lie on parallel planes.

FIGS. 1, 2 and 3 illustrate a first example cannula 100. The cannula 100is an elongate tubular member having a circumferential wall 112extending between a proximal end 114 and a distal end 116. Thecircumferential wall 112 defines an interior lumen 118. A proximalopening 120 on the proximal end 114 provides access to the interiorlumen 118. Similarly, a distal opening 122 on the distal end 116provides access to the interior lumen 118. A longitudinal axis 101extends centrally through the lumen. As best illustrated in FIG. 2 ,each of a plurality of transverse axes, such as transverse axis 102,lies on an individual plane that orthogonally intersects thelongitudinal axis 101 at a point along its length.

A pattern of openings 124 extends along a portion of the axial length ofthe cannula 100. In the illustrated example, the pattern of openings 124extends along the entire axial length of the cannula 100, extendingbetween the proximal 114 and distal 116 ends. The pattern of openings124 can extend along any suitable portion of the axial length of thecannula 100, though, and the entire axial length, as in the illustratedcannula 100, is only an example. For a cannula according to a particularexample, a skilled artisan will be able to select a suitable portion ofthe axial length of the cannula along which the pattern of openings isto extend based on various considerations, including any need or desirefor axial portions having a greater stiffness than that provided by anaxial portion along which the pattern of openings extends. For example,if it is desirable to have an axial portion that has the globalstiffness of the cannula material itself, the cannula can be made sothat the pattern of openings does not extend along the axial portion forwhich the global stiffness is desired. Each of FIGS. 5, 6, and 7 ,described in detail below, illustrates an example cannula in which thepattern of openings does not extend along the entire axial length of thecannula.

As best illustrated in FIG. 2 , the pattern of openings 124 comprises aplurality of openings 126 arranged in an interrupted spiral 128 thatextends circumferentially along the circumferential wall 112 of thecannula 100. In the illustrated embodiment, each opening 130 of theplurality of openings 126 comprises a slit that extends through theentire wall thickness of the circumferential wall 112 to provide accessto the lumen 118 of the cannula 100. The slit of each opening has agenerally rectangular shape having a major axis m disposed on a planethat is transverse to the longitudinal axis 101 of the cannula 100. Oneend 132 of the slit of each opening 130 has a slightly enlarged width,measured along the minor axis of the oblong rectangle of the slit. Theoverall pattern of openings 124 takes a spiral 128 configurationrelative to the longitudinal axis of the cannula 100 because the majoraxis m of each opening is disposed on a plane that intersects thelongitudinal axis 101 of the cannula 100 at a non-orthogonal angle a.Thus opening 134 in FIG. 2 , which is illustrated relative tolongitudinal axis 101 and transverse axis 102 of cannula 100, isslightly skewed relative to transverse axis 102, as are all otheropenings 130 in the plurality of openings 124.

The inventors have determined that various parameters of the pattern ofopenings 124 can be manipulated to achieve a desired stiffness in thecannula 100 along an axial portion of the cannula 100. For example, thedistance between revolutions of the spiral, illustrated in FIG. 2 as thegap 136 between openings 130 in immediately adjacent revolutions of thespiral, can be increased or decreased to achieve a desired number ofrevolutions of the spiral per unit of length of the cannula 100, which,in turn, increases or decreases, respectively, the stiffness of thecannula along the axial portion containing the pattern of openings 124.Stated differently, the pitch of the spiral path along which theopenings extend on the cannula can be increased or decreased to achievea desired stiffness along the axial portion containing the pattern ofopenings 124. Also, the distance between openings within a revolution ofthe spiral, illustrated in FIG. 2 as the gap 138 between openings, canbe increased or decreased to achieve a desired number of openings in arevolution of the spiral. The major length 140 of the oblong rectangleformed by the openings 130 can be varied as well. Also, the ratio of themajor length 140 of the oblong rectangle of the opening to the distancebetween openings within a revolution of the spiral, i.e., gap 138, canbe increased or decreased to achieve a desired number of openings in arevolution of the spiral, which, in turn, increases or decreases,respectively, the stiffness of the cannula along the axial portioncontaining the pattern of openings 124. The angle a at which a planecontaining the major axis m of individual openings 130 intersects thelongitudinal axis 101 of the cannula 100 can also be increased ordecreased to achieve a desired flexibility.

A skilled artisan will be able to manipulate one or more of theseparameters in a cannula according to a particular embodiment to achievea desired flexibility along the axial portion containing a pattern ofopenings. Surprisingly, the inventors have determined that a cannulamade in this manner retains enough stiffness to effectively serve as theinnermost member of a delivery system useful for placing an intraluminalmedical device at a point of treatment within a body vessel. Whileproviding a desired degree of local flexibility through manipulation ofthe parameters described above, such a cannula is able to carry theintraluminal medical device of the delivery system, such as a stent,valve, filter or other expandable intraluminal medical device, and,effectively, serve as a pusher that provides the pushability and/ortrackability needed for navigation of the delivery system to anintraluminal point of treatment.

Indeed, while the openings 130 in the illustrated embodiment compriseslits, any suitable opening can be used in a cannula according to aparticular embodiment, including openings that provide rectangularpassages, openings that provide generally rectangular passages, openingsthat provide square passages, openings that provide generally squarepassages, openings that provide circular passages, openings that providegenerally circular passages, openings that provide triangular passages,openings that provide generally triangular passages, and openings thatprovide irregular passages. The inventors have determined, though, thatslits are particularly advantageous at least because of the relativeease with which they can be formed in an elongate tubular member and theease with which they can be aligned along a spiral path on an elongatetubular member.

Each of FIGS. 4A, 4B, and 4C illustrates an alternative cannula withwall openings arranged in an alternative pattern achieved bymanipulating one or more of the parameters described above. In thecannula 100′ illustrated in FIG. 4A, the gap 136′ between openings 130′in immediately adjacent revolutions of the spiral is larger than the gap136 used in cannula 100 illustrated in FIGS. 1 through 3 .

The gap between openings in immediately adjacent revolutions of thespiral in a cannula according to a particular embodiment can have anysuitable length as measured along the longitudinal axis of the cannula.A skilled artisan will be able to select an appropriate length for thisgap for a particular cannula according to various considerations,including the nature of the material from which the cannula is formedand any desired flexibility in the axial length of the cannula alongwhich the pattern of openings that contains the gaps extends. Theinventors have determined that a gap the is between about 0.5 and about40.0 times the axial width of the openings in the pattern of openings issuitable for a cannula intended to be used in an intraluminal medicaldevice delivery system as described herein. The inventors also considera gap that is between about 1 and about 5 times the axial width of theopenings in the pattern of openings to be suitable for a cannulaintended to be used in an intraluminal medical device delivery system asdescribed herein. The inventors also consider a gap that is betweenabout 1.5 and about 2.5 times the axial width of the openings in thepattern of openings to be suitable for a cannula intended to be used inan intraluminal medical device delivery system as described herein. Theinventors also consider a gap that is about 2 times the axial width ofthe openings in the pattern of openings to be suitable for a cannulaintended to be used in an intraluminal medical device delivery system asdescribed herein.

In the cannula 100″ illustrated in FIG. 4B, the gap 138″ betweenopenings 130″ within a revolution of the spiral is larger than the gap138 used in cannula 100 illustrated in FIGS. 1 through 3 .

The gap between openings within a revolution of the spiral in a cannulaaccording to a particular embodiment can have any suitable length asmeasured along the major axis of the openings of revolution. A skilledartisan will be able to select an appropriate length for this gap for aparticular cannula according to various considerations, including thenature of the material from which the cannula is formed and any desiredflexibility in the axial length of the cannula along which the patternof openings that contains the gaps extends. The inventors havedetermined that a gap that is between about 0.1 and about 2 times theaxial length of the openings in the pattern of openings is suitable fora cannula intended to be used in an intraluminal medical device deliverysystem as described herein. The inventors consider a gap that is betweenabout 0.25 and about 1.5 times the axial length of the openings in thepattern of openings to be suitable for a cannula intended to be used inan intraluminal medical device delivery system as described herein. Theinventors also consider a gap that is between about 0.5 and about 1.25times the axial length of the openings in the pattern of openings to besuitable for a cannula intended to be used in an intraluminal medicaldevice delivery system as described herein. The inventors also considera gap that is about 0.5 times the axial length of the openings in thepattern of openings to be suitable for a cannula intended to be used inan intraluminal medical device delivery system as described herein.

In the cannula 100′″ illustrated in FIG. 4C, the angle a′″ at which eachof the planes containing a major axis of an opening 130′″ intersects thelongitudinal axis 101′″ of the cannula 100′″ is smaller, or more acute,than the angle a used in cannula 100 illustrated in FIGS. 1 through 3 .

The angle at which each of the planes containing a major axis of anopening intersects the longitudinal axis of a cannula according to aparticular embodiment can have any suitable measure. A skilled artisanwill be able to select an appropriate measure for this angle for aparticular cannula according to various considerations, including thenature of the material from which the cannula is formed and any desiredflexibility in the axial length of the cannula along which the patternof openings that contains the angle extends. The inventors havedetermined that an angle that is between about 5 degrees and about 89degrees is suitable for a cannula intended to be used in an intraluminalmedical device delivery system as described herein. The inventorsconsider an angle that is between about 45 degrees and about 89 degreesto be suitable for a cannula intended to be used in an intraluminalmedical device delivery system as described herein. The inventors alsoconsider an angle that is between about 75 degrees and about 89 degreesto be suitable for a cannula intended to be used in an intraluminalmedical device delivery system as described herein. The inventors alsoconsider an angle that is about 85 degrees to be suitable for a cannulaintended to be used in an intraluminal medical device delivery system asdescribed herein. Also, it is noted that the angle can be disposed ineither direction relative to the cannula. As a result, the openings inthe pattern of openings in a cannula according to a particularembodiment can extend toward the proximal end of the cannula or towardthe distal end of the cannula.

In the first example cannula 100, the pattern of openings 124 is uniformin that the various parameters described above—the distance betweenrevolutions of the spiral, i.e., gap 136 and, therefore, the pitch ofthe spiral path along which the openings 130 extend, the distancebetween openings within a revolution of the spiral, i.e., gap 138, themajor length 140 of the oblong rectangle formed by the openings 130, theratio of the major length 140 of the oblong rectangle of the openings130 to the distance between openings within a revolution of the spiral,i.e., gap 138, of the openings 130—are uniform throughout the pattern ofopenings 124. That is, the each of the parameters has a substantiallyconstant value that does not vary within the axial portion of thecannula along which the pattern of openings 124 extends. For somecannula, though, it may be desirable to have one or more of theseparameters vary within the axial portion of the cannula along which thepattern of openings 124 extends.

FIG. 5 illustrates an example cannula 200 in which some of theseparameters vary within the axial portion of the cannula 200 along whichthe pattern of openings 224 extends. For example, an intermediateportion 224 a of the pattern of openings includes a first distancebetween revolutions of the spiral, i.e., gap 236 a, and a first distancebetween openings within a revolution of the spiral, i.e., gap 238 a. Aproximal portion 224 b of the pattern of openings includes a seconddistance between revolutions of the spiral, i.e., gap 236 b, and asecond distance between openings within a revolution of the spiral,i.e., gap 238 b. Gap 236 b is shorter in length that gap 236 a.Similarly, gap 238 b is shorter in length that gap 238 a. A distalportion 224 c of the cannula 200 is free of the pattern of openings 224.This construction, where one or more of the parameters described aboveis varied within a single plurality of openings along an axial portionof a cannula, can be advantageously used in a cannula according to aparticular example to provide a stiffness transition between an axialportion of relatively low stiffness, such as proximal portion 224 b incannula 200, to an axial portion of the cannula of relatively highstiffness, such as distal portion 224 c of cannula 200, along which thepattern of openings 224 does not extend.

While the pattern of openings can extend along the entire axial lengthof a cannula, such as in the first example cannula 100, a pattern ofopenings can extend along any suitable axial length of a cannulaaccording to a particular embodiment. A skilled artisan will be able toselect an appropriate axial length for a pattern of openings in acannula according to a particular embodiment based on variousconsiderations, including whether it is desirable to include any axialportions of the cannula that have a localized stiffness that is greaterthan the stiffness of the axial portions along which the pattern ofopenings extends. Each of FIGS. 6, 7, and 8 illustrates a cannula havinga pattern of openings that extends along only a portion, or portions, ofthe entire axial length of the example cannula.

The cannula 300 illustrated in FIG. 6 has a pattern of openings 310 thatextends along an intermediate portion 350 of the axial length of thecannula 300. The pattern of openings 310 can be any suitable pattern ofopenings according to an embodiment, including those described above.The intermediate portion 350 extends between a proximal portion 352 anda distal portion 354, each of which is free of the pattern of openings310 and, indeed, comprises a solid, non-interrupted circumferentialwall. This structural configuration is considered advantageous at leastbecause it provides a relatively stiff distal portion 354 that issuitable for carrying an intraluminal medical device when the cannula300 is included as a component in a delivery system, such as thosedescribed below. Furthermore, this configuration provides a relativelystiff proximal portion 352 that facilitates manipulation of the cannula300, or a delivery system that includes the cannula, by a user.

Each of the intermediate 350, proximal 352 and distal 354 portions canextend along any suitable axial length of the cannula 300, and a skilledartisan will be able to determine suitable axial lengths for eachportion in a particular cannula based on various considerations,including the axial length of any intraluminal medical device with whichthe cannula is intended to be used. Furthermore, the portions can haveany suitable relative axial lengths. For example, in the illustratedembodiment, the proximal portion 352 is longer than the distal portion354. It is noted, though, that an opposite relationship could be used,i.e., the distal portion of a cannula can have a longer axial lengththan a proximal portion.

The cannula 400 illustrated in FIG. 7 has a pattern of openings 410 thatextends along a distal portion 454 of the axial length of the cannula400. The pattern of openings 410 can be any suitable pattern of openingsaccording to an embodiment, including those described above. The distalportion 454 includes the distal end 456 of the cannula 400. A proximalportion 452 is free of the pattern of openings 410 and, indeed,comprises a solid, non-interrupted circumferential wall. This structuralconfiguration is considered advantageous at least because it provides arelatively flexible distal portion 454 that is suitable for carryingsome intraluminal medical devices through tortuous anatomy, such asneurovascular stents. Furthermore, this configuration provides arelatively stiff proximal portion 452 that facilitates manipulation ofthe cannula 400, or a delivery system that includes the cannula, by auser.

Each of the proximal 452 and distal 454 portions can extend along anysuitable axial length of the cannula 400, and a skilled artisan will beable to determine suitable axial lengths for each portion in aparticular cannula based on various considerations, including the axiallength of any intraluminal medical device with which the cannula isintended to be used. Furthermore, the portions can have any suitablerelative axial lengths. For example, in the illustrated embodiment, theproximal portion 452 is shorter than the distal portion 454. It isnoted, though, that an opposite relationship could be used, i.e., thedistal portion of a cannula can have a longer axial length than aproximal portion.

The cannula 500 illustrated in FIG. 8 has a pattern of openings 510 thatcomprises distinct sections 510 a, 510 b, and 510 c that are separatedfrom each other by intervening sections 562, 564. The cannula 500 alsoincludes a proximal portion 552 and a distal portion 554, each of whichis free of the pattern of openings 510 and, indeed, comprises a solid,non-interrupted circumferential wall. In each of the distinct sections510 a, 510 b, 510 c, the pattern of openings 510 can be any suitablepattern of openings according to an embodiment, including thosedescribed above. Furthermore, the pattern of openings in each of thedistinct sections 510 a, 510 b, 510 c can be the same pattern as in theother distinct sections 510 a, 510 b, 510 c. Alternatively, the patternof openings in each of the distinct sections 510 a, 510 b, 510 c can bedifferent from the pattern of openings in one or two of the otherdistinct sections 510 a, 510 b, 510 c. Also, each of the distinctsections 510 a, 510 b, 510 c can have any suitable axial length alongthe cannula 500. In the illustrated embodiment, each of the distinctsections 510 a, 510 b, 510 c extends along an axial length of thecannula 500 that is the same as the axial length along which the otherof the distinct sections 510 a, 510 b, 510 c extends along. It is noted,though, that each of the distinct sections 510 a, 510 b, 510 c canextend along an axial length that is different from the axial lengthalong which one or more of the other distinct sections 510 a, 510 b, 510c extends along. Also, in any given embodiment, any suitable number ofdistinct sections can be used.

In some embodiments, one or more openings in the pattern of openingsthat are positioned at specific locations on the cannula are arrangedrelative to other openings in the pattern of openings such that theseopenings vary from the interrupted spiral that extends circumferentiallyalong the circumferential wall of the cannula. This structuralconfiguration can be used to provide desired structural characteristics,such as preferential bending and resistance to bending, at distinctlocations within the pattern of openings and, indeed, on the cannulaitself. This structural arrangement can provide particular desirablecharacteristics when a particular lengthwise axis that lies on thecircumferential surface of a cannula is designated as the specificlocation for openings that vary from the interrupted spiral that extendsalong the circumferential wall of the cannula.

FIGS. 9, 10 and 11 illustrate an example cannula 600 in which allopenings that intersect a particular lengthwise axis 602 that lies onthe circumferential surface 604 of the cannula 600 are disposed at anangle relative to the central longitudinal axis 601 of the cannula 600that is different than the angle at which openings that do not intersectlengthwise axis 602 are disposed relative to the central longitudinalaxis 601 of the cannula 600. Thus, as best illustrated in FIG. 10 ,cannula 600 has a pattern of openings 610 that includes a first set ofopenings 620 that are disposed on planes 622, 624 that intersect thecentral longitudinal axis 601 at a first angle a₁ and a second set ofopenings 630 that are disposed on planes, such as plane 632, thatintersect the central longitudinal axis 601 at a second angle a₂.Circumferentially, as best illustrated in FIG. 11 , each of the openingsin the second set of openings 630 intersects the particular lengthwiseaxis 602 and, therefore, intersects a particular circumferential point650.

In these embodiments, the first a₁ and second a₂ angles can differ byany suitable amount, and a skilled artisan will be able to select asuitable difference between the angles in a cannula according to aparticular embodiment based on various considerations, including anydesired degree of stiffness balances against any desired structuralcharacteristic provided by the use of first and second angles, such aspreferential bending. Furthermore, both angles can be acute or obtuse,or one angle can be acute and another can be obtuse. The illustratedembodiment, in which both the first a₁ and second a₂ angles are acutebut first a₁ angle is greater than the second a₂ angle, is one examplestructural arrangement of many that can be used.

It is noted that, while alternate angles relative to the centrallongitudinal axis 601 have been described and illustrated, otherstructural characteristics of the openings that intersect a particularlengthwise axis can differ from other openings in a particular cannulato achieve a desired overall structural characteristics for the cannula.For example, the length, width and even shape and configuration of theintersecting openings can be altered to suitable parameters to achieve adesired characteristic.

Providing different structural characteristics for openings thatintersect a particular longitudinal axis of a cannula, as describedabove, can provide particularly desirable performance characteristicsfor a cannula when the axis of intersection lies along a seam in acannula roll-formed from an initially flat ribbon and joined to form atube, such as by welding along the seam. FIGS. 12A, 12B, and 12Cillustrate example cannulae 700, 800, 900 formed in this manner.

In FIG. 12A, cannula 700 has a pattern of openings 710 that includes afirst set of openings 720 that are disposed on planes, such as planes722, 724, that intersect the central longitudinal axis 701 at a firstangle a₁ and a second set of openings 730 that are disposed on planes,such as plane 732, that intersect the central longitudinal axis 701 at asecond angle a₂ that is different than the first angle a₁. Each openingin the second set of openings 730 intersects a longitudinal axis 702that lies along a longitudinal seam 703 in the cannula 700.

In FIG. 12B, cannula 800 has a pattern of openings 810 that includes afirst set of openings 820 and a second set of openings 830. Each openingin the second set of openings 830 intersects a longitudinal axis 802that lies along a longitudinal seam 803 in the cannula 800. In thisembodiment, each opening in the second set of openings 830 has a largerwidth and length than that of each opening in the first set of openings820. Thus, each opening of the second set of openings 830 has a greatertotal open area than each opening in the first set of openings 820.

In FIG. 12C, cannula 900 has a pattern of openings 910 that onlyincludes a first set of openings 920. There are no openings in thepattern of openings 910 that intersect a longitudinal axis 902 that liesalong a longitudinal seam 903 in the cannula 900. Any opening that wouldintersect the longitudinal axis 902 and longitudinal seam 903 due to theregular pattern of the pattern of openings 910 extending along a spiralpath on the circumferential surface 904 of the cannula has been omittedfrom the pattern of openings and never formed in the cannula. Thisstructural arrangement may be beneficial in cannulae in which a greaterdegree of stiffness is desired along a particular lengthwise axis, suchas one that lies along a lengthwise seam.

Inclusion of a second pattern of openings within a first pattern ofopenings can also provide desirable performance characteristics for acannula. Thus, a cannula can include a second pattern of openings thatextends along any suitable axial portion of the axial length along whichthe first pattern of openings extends. In these embodiments, the secondpattern of openings can have the same or different structural propertiesof the first pattern of openings. For example, the second pattern ofopenings can have openings of the same size, shape and configuration asthose of the first pattern of openings and the second pattern ofopenings can extend along a spiral path on the cannula having the samepitch as that along which the first pattern of openings extends.Alternatively, the second pattern of openings can have openings havingdifferent structural properties of those of the first pattern ofopenings and/or the openings of the second pattern of openings canextend along a spiral path on the cannula that has a different pitchthan that along which the first pattern of openings extends.

FIG. 13 illustrates an example cannula 1000 having first 1080 and second1090 patterns of openings. The second pattern of openings 1090 extendsalong an axial portion 1092 of the axial length 1082 along which thefirst pattern of openings 1080 extends. In the illustrated embodiment,the axial portion 1092 is located within the axial length 1082 such thatthe axial length 1082 includes proximal 1084 and distal 1086 regionsthat extend beyond the axial portion 1092. Also, cannula 1000 includesproximal 1050 and distal 1060 axial portions that are free of bothpatterns of openings 1080, 1090. In the illustrated embodiment, thesecond pattern of openings 1090 extends along a spiral path on thecircumference of the cannula that has a different pitch, a greaterpitch, than the pitch of the spiral path along which the first patternof openings 1080 extends. As noted above, the first 1080 and second 1090pattern of openings can extend along spiral paths having differentpitches, as illustrated, or the same pitches. Also, the openings in thefirst second 1090 patterns of openings in the illustrated embodiment arelonger and wider than the openings in the first pattern of openings. Asnoted above, the openings of the first 1080 and second 1090 patterns ofopenings can have different structural characteristics, as illustrated,or can have identical or substantially identical structuralcharacteristics.

A cannula can include one or more additional components. For example, toachieve desired structural and/or performance characteristics for acannula, an inner member, such as a polymeric shaft or wire member, canbe disposed within the lumen defined by a cannula. An outer member, suchas an outer sheath or coating, can be disposed circumferentially about acannula.

FIGS. 14 and 15 illustrate an example cannula 1100 around which an outersheath 1175 has been disposed. In the illustrated embodiment, the outersheath 1175 comprises a length of tubing that has been disposedcircumferentially about the elongate member of the cannula 1100 andshrunk down onto the circumferential surface of the cannula, such as byexposure to heat. Inclusion of an outer sheath in this manner can beadvantageous when certain properties are desired for the cannula. Forexample, the inclusion of an outer Teflon or polyurethane sheath canprovide lubriciousness for the cannula, which may be desirable when thecannula is intended to be used as an outer member in a delivery systemor on its own.

In these embodiments, the openings of the pattern of openings can becovered by the outer sheath. Alternatively, the outer sheath can bedisrupted to provide access to one, at least one, some, a plurality of,or all of the openings of the pattern of openings. This may be desirablewhen fluid access between the lumen of the cannula and the externalenvironment is desired, such as when fluid flushing from the lumen tothe external environment, or vice versa, is desired. In the illustratedembodiment, a first set of openings 1120 of the pattern of openingsremain covered by the outer sheath 1175 while the outer sheath 1175includes disruptions 1130 that provide access to a second set 1140 ofopenings of the pattern of openings 1110. In this embodiment, eachopening of the second set of openings 1140 intersects a longitudinalseam 1103 of the cannula 1100, which lies on a longitudinal axis 1102 onthe circumferential surface 1104 of the cannula 1100. The disruptions1130 in the outer sheath 1175 provide access to the lumen 1118 definedby the cannula 1110. Thus, as best illustrated in FIG. 15 , thedisruptions 1130 and the points at which fluid access to the lumen 1118exists, have a known circumferential position on the cannula 1100—thelongitudinal seam 1103.

As an alternative to disrupting an outer sheath to provide fluidcommunication between the lumen defined by the cannula and the externalenvironment, multiple outer sheaths can be disposed circumferentiallyabout the cannula such that they are axially spaced from each otheralong the length of the cannula, leaving an axial gap between them. Bypositioning the axial gap or gaps at axial locations that includeopenings in a pattern of openings disposed on the cannula, the desiredfluid communication is established even though the outer sheaths are notdisrupted and the openings they extend over are, effectively, blocked.

A cannula according to an example can be made of any suitable material.A skilled artisan will be able to select an appropriate material for acannula according to a particular example based on variousconsiderations, including any desired overall stiffness and/orflexibility of the cannula and the point of treatment at which thecannula is intended to be used. Metals are considered advantageous forthe examples described and illustrated herein, but polymeric, includingplastic materials currently considered suitable for use in medicaldevices, and other materials can be used. Stainless steel is consideredparticularly advantageous for the example cannulae described andillustrated herein at least because of its well-characterized nature,acceptance as a material used in medical devices temporarily placedwithin body lumens, and ready availability. Examples of other metalsconsidered suitable for use in cannulae according to particular examplesinclude cobalt-chrome and shape memory alloys, such as nickel-titaniumalloys. Examples of polymeric materials considered suitable for use incannulae according to particular examples include polyamide materials,such as nylon, and other polymeric materials. A cannula can includemultiple materials, too, if desired. For example, an axial length of onematerial can be joined to an axial length of another material to createa cannula. The pattern of openings in such a cannula can be disposed onany suitable axial portion of the cannula, such as an axial portioncomprising only the first material, an axial portion comprising only thesecond material, or an axial portion comprising both the first and thesecond material.

It is noted that a cannula according to a particular example can have alumen of any suitable diameter and that the dimensions of the lumen ofthe cannulae described and illustrated herein are illustrative only. Askilled artisan will be able to select an appropriate lumen size for acannula according to a particular example based on variousconsiderations, including the dimensions of the lumen of the body vesselwithin which the cannula and/or delivery system is intended to be used.

It is noted that a cannula according to a particular example can have acircumferential wall of any suitable wall thickness and that the wallthicknesses of the circumferential wall of the cannulae described andillustrated herein are illustrative only. A skilled artisan will be ableto select an appropriate wall thickness for a cannula according to aparticular embodiment based on various considerations, including anydesired overall stiffness of the cannula. Indeed, the inventors havedetermined that a wall thickness can be selected when making a cannulaaccording to a particular example that provides a desired stiffness toany axial portions of the cannula not having a pattern of openingsdisposed on the portion of the circumferential wall within thatparticular axial portion. As described in detail below, combining aselected wall thickness with one or more selected patterns of openingsalong the axial length of a cannula allows a user to make a cannula withdesired global and local stiffnesses.

The cannulae can be used as a component of a delivery system useful fordelivering an intraluminal medical device to a point of treatment withina lumen of a body vessel. Indeed, structural characteristics of thecannulae make the cannulae useful as various components of a deliverysystem. For example, the cannulae can be used as an inner core member ina delivery system, as a pusher in a delivery system, and/or as an outertubular member of a delivery system. When used as one or more of thesecomponents in a delivery system, the desirable stiffness properties ofthe cannulae provide delivery systems that are particularly well suitedfor delivering a variety of intraluminal medical devices to points oftreatment within various body vessels. For example, delivery systemsthat include example cannulae are expected to be well-suited fordelivery of prosthetic venous valves, stents, filters, occluders,neurovascular stents and other intraluminal medical devices.

Inclusion of a cannula as an inner core member in a delivery system maybe advantageous where an intended point of treatment and/or navigationroute makes localized flexibility desirable. In these embodiments, anintraluminal medical device can be disposed circumferentially about, andcarried by, the cannula, which is then surrounded by an outer elongatetubular member, such as a conventional delivery system sheath.

FIG. 16 illustrates a first example delivery system 1200 in which acannula according to an embodiment is included as an inner core member.The delivery system 1200 includes a cannula 1210 according to anembodiment disposed within the lumen 1214 defined by an outer tubularmember 1212. An intraluminal medical device 1216 is circumferentiallydisposed around the cannula 1210 and within the lumen 1214 of the outertubular member 1212.

The cannula 1210 can comprise any suitable cannula according to anembodiment and a skilled artisan will be able to select a suitablecannula for inclusion in a particular delivery system based on variousconsiderations, including the nature, size and configuration of theintraluminal medical device 1216 and any desired local and/or globalflexibility and/or stiffness properties for the delivery system 1200. Inthe illustrated delivery system 1200, a cannula 1210 having a pattern ofopenings 1220 that extends along the entire axial length of the cannula1210 is included in the delivery system 1200. This is consideredparticularly advantageous for delivery systems for which overallflexibility is the primary desired characteristic.

The intraluminal medical device 1216 can comprise any suitableintraluminal medical device. The delivery systems are particularlywell-suited, however, for use with self-expandable medical devices,including stents, valves, such as venous valve and cardiac valves,filters, occluders, and other intraluminal medical devices.

Additional components can be attached to the cannula 1210 usingconventional approaches. For example, in the illustrated embodiment, aconical distal tip 1270 has been disposed on and secured to the distalend of the cannula 1210. Similarly, additional components can beattached to the elongate tubular member 1214 using conventionalapproaches. For example, in the illustrated embodiment, a hub 1280providing a side-arm connector 1282 is disposed on and secured to theproximal end of the elongate tubular member 1212.

It is noted that the cannula 1210 provides desirable flexibility andpushability characteristics for the delivery system 1200 such thatadditional components, such as a pusher, are not required for its use.Thus, the delivery system can consist only of a cannula according to anembodiment, such as cannula 1210, an elongate tubular member 1212, andan intraluminal medical device 1216. If desired or necessary, thedelivery system 1200 can be advanced over a previously-placed wireguide(not shown) for conventional navigation purposes.

FIG. 17 illustrates a second example delivery system 1300 in which acannula according to an embodiment is included as an inner core member.Delivery system 1300 is similar to delivery system 1200 described aboveand illustrated in FIG. 16 , except as detailed below. Thus, deliverysystem 1300 includes a cannula 1310 according to an embodiment disposedwithin the lumen 1314 defined by an outer tubular member 1312. Anintraluminal medical device 1316 is circumferentially disposed aroundthe cannula 1310 and within the lumen 1314 of the outer tubular member1312. An elongate double-tapered distal tip 1370 has been disposed onand secured to the distal end of the cannula 1310. A hub 1380 providinga side-arm connector 1382 is disposed on and secured to the proximal endof the elongate tubular member 1312.

The delivery system 1300 also includes tubular pusher 1320 that isslidably disposed over the cannula 1310. During use, the tubular pusher1320 can be axially advanced over the cannula 1310 toward theintraluminal medical device 1316 until the distal end 1322 of thetubular pusher 1320 abuts or otherwise engages the proximal end of theintraluminal medical device 1316. At that point, the tubular pusher 1320can continue to be distally advanced, thereby forcing distal advancementof the intraluminal medical device 1316 until it exits the lumen 1314defined by the outer tubular member 1312. Alternatively, the outertubular member 1312 can be proximally withdrawn while the position ofthe tubular pusher 1320 is maintained until the intraluminal medicaldevice 1316 exits the lumen 1314 defined by the outer tubular member1312.

The cannula 1310 can comprise any suitable cannula according to anembodiment and a skilled artisan will be able to select a suitablecannula for inclusion in a particular delivery system based on variousconsiderations, including the nature, size and configuration of theintraluminal medical device 1316 and any desired local and/or globalflexibility and/or stiffness properties for the delivery system 1300. Inthe illustrated embodiment, the cannula 1310 is similar to the cannula300 illustrated in FIG. 6 . Thus, the cannula 1310 has a pattern ofopenings 1330 that extends along an intermediate portion 1352 of theaxial length 1350 of the cannula 1310. The pattern of openings 1310 canbe any suitable pattern of openings according to an embodiment,including those described above. The intermediate portion 1352 extendsbetween a proximal portion 1354 and a distal portion 1356, each of whichis free of the pattern of openings 1300 and, indeed, comprises a solid,non-interrupted circumferential wall. This structural configuration isconsidered advantageous at least because it provides a relatively stiffdistal portion 1356 that is suitable for carrying the intraluminalmedical device 1316 and provides a relatively stiff proximal portion1354 that facilitates manipulation of the delivery system 1300 duringuse. This arrangement is considered advantageous for use with lowprofile intraluminal medical devices, such as stents.

FIG. 18 illustrates an example delivery system 1400 in which a cannulaaccording to an embodiment is included as a pusher and, along with anintraluminal medical device, is disposed circumferentially about aninner member. In this embodiment, delivery system 1400 includes acannula 1410 according to an embodiment disposed within the lumen 1414defined by an outer tubular member 1412. An intraluminal medical device1416 is circumferentially disposed within the lumen 1414 of the outertubular member 1412 and distal to the cannula 1410. In this embodiment,the intraluminal medical device is not disposed about the cannula 1410in the fully assembled delivery system 1400. A hub 1480 providing aside-arm connector 1482 is disposed on and secured to the proximal endof the elongate tubular member 1412.

In this embodiment, the cannula 1410 and intraluminal medical device1416 are each circumferentially disposed about an inner core member1440, such as a solid core member, a lumen-defining member, or a wire.As such, the cannula 1410 is positioned for use as a pusher on theintraluminal medical device 1416. Thus, during use, the cannula 1410 canbe axially advanced over the inner core member 1440 toward theintraluminal medical device 1416 until the distal end 1422 of thecannula 1410 abuts or otherwise engages the proximal end 1424 of theintraluminal medical device 1416. At that point, the cannula 1410 cancontinue to be distally advanced, thereby forcing distal advancement ofthe intraluminal medical device 1416 until it exits the lumen 1414defined by the outer tubular member 1412. Alternatively, the outertubular member 1412 can be proximally withdrawn while the position ofthe cannula 1410 is maintained until the intraluminal medical device1416 exits the lumen 1414 defined by the outer tubular member 1412.

The cannula 1410 can comprise any suitable cannula according to anembodiment and a skilled artisan will be able to select a suitablecannula for inclusion in a particular delivery system based on variousconsiderations, including the nature, size and configuration of theintraluminal medical device 1416 and any desired local and/or globalflexibility and/or stiffness properties for the delivery system 1400. Inthe illustrated embodiment, the cannula 1410 is similar to the cannula1000 illustrated in FIG. 13 . Thus, the cannula 1410 has a first patternof openings 1450 that extends along a first axial length 1460 of thecannula 1410 and a second pattern of openings 1470 that extends along asecond axial length 1470 of the cannula 1410. The second axial length1460 is a portion of the first axial length 1480, which provides anaxial length 1490 of the cannula 1410 along which both the first 1450and second 1470 pattern of openings extend. In the illustratedembodiment, the second pattern of openings 1470 is a plurality ofopenings that extends linearly along only a single side of theintermediate axial portion of the cannula 1410. Also, the openings ofthe second pattern of openings 1470 are interspersed with the openingsof the first pattern of openings 1450. This structural configuration isconsidered advantageous at least because it provides a relatively stiffdistal portion 1456 that is suitable for contacting and pushing theintraluminal medical device 1416 and provides an axial length 1490having enhanced flexibility.

FIG. 19 illustrates an example delivery system 1500 in which a cannula1510 according to an embodiment is included as an outer tubular memberthat is disposed circumferentially about inner components of thedelivery system. That is, an inner member, such as a dilator 1512 onwhich an intraluminal medical device 1516 is circumferentially disposed,is disposed within a lumen 1514 defined by the cannula 1510. In thisembodiment, the cannula 1510 includes a full-length outer sheath 1550disposed over and secured to the cannula 1510. The cannula 1510 includesa pattern of openings 1520. A first set of openings 1522 of the patternof openings 1520 are covered by the outer sheath and a second set ofopenings 1524 are adjacent disruptions 1552 in the outer sheath 1550that establish communication between the external environment and thelumen 1514 defined by the cannula 1510. This structural configuration isconsidered advantageous at least because it provides fluid communicationchannels that can be used for flushing the delivery system 1500 before,during or after deployment of the intraluminal medical device 1516 at apoint of treatment.

FIG. 20 illustrates an example method 1600 of making a cannula. A firststep 1602 comprises identifying a cannula material and a cannula wallthickness that provides a desired global stiffness for said cannula.Another step 1604 comprises identifying one or more axial lengths ofsaid cannula along which a localized stiffness, different from thedesired global stiffness, is desired. Another step 1606 comprisesidentifying a pattern of openings that will provide the desiredlocalized stiffness when cut into a cannula formed of the cannulamaterial and having the cannula wall thickness. Another step 1608comprises cutting the pattern of openings into a cannula formed of thecannula material and having the cannula wall thickness at axialpositions that correspond to the one or more axial lengths.

FIG. 21 illustrates another example method 1700 of making a cannula. Afirst step 1702 comprises rolling a section of flat stock to form aslotted tube in which opposite sides of the flat stock are disposedopposite one another relative to a slot in the slotted tube. Anotherstep 1704 comprises securing the opposite sides to one another, toclose, substantially close, or partially close the slot to form acannula. Another step 1706 comprises cutting a pattern of openings intothe cannula.

The step 1702 of rolling a sheet of flat stock can be performed in anysuitable manner and using any suitable technique and/or equipment. Thestep 1704 of securing the opposite sides to one another can be performedin any suitable manner and using any suitable technique and/orequipment. Welding the sides to each other and adhering the sides toeach other are examples of suitable techniques that can be used. Thestep 1706 of cutting a pattern of openings into the cannula can beperformed in any suitable manner and using any suitable technique and/orequipment. Furthermore, any suitable pattern of openings can be madeduring performance of this step, including the various patterns ofopenings described and illustrated herein. In an alternative method aninitial step of cutting a pattern of openings into the section of flatstock is included. In another alternative method, the step 1706 ofcutting a pattern of openings into the cannula is eliminated and aninitial step of cutting a pattern of openings into the section of flatstock is included.

FIG. 22 is a schematic illustration of a transformation of matter thatoccurs with performance of steps of the method illustrated in FIG. 21 .A section of flat stock, such as ribbon 1800, is rolled to form slottedtube 1802 having longitudinal slot 1804. A longitudinal weld join 1806is formed to close longitudinal slot and to form cannula 1808. A patternof openings can then be cut into the cannula 1806 using any suitabletechnique and/or process, such as laser cutting followed bypost-processing to remove any slag created as a result of the cutting.Alternatively, a suitable laser capable of cutting the pattern ofopenings entirely by vaporization can be used to avoid the need forremoval of slag in post-processing.

FIG. 23 illustrates an example method 1800 of making a delivery system.A first step 1802 comprises identifying a cannula material and a cannulawall thickness that provides a desired global stiffness for saidcannula. Another step 1804 comprises identifying one or more axiallengths of said cannula along which a localized stiffness, differentfrom the desired global stiffness, is desired. Another step 1806comprises identifying a pattern of openings that will provide thedesired localized stiffness when cut into a cannula formed of thecannula material and having the cannula wall thickness. Another step1808 comprises cutting the pattern of openings into a cannula formed ofthe cannula material and having the cannula wall thickness at axialpositions that correspond to the one or more axial lengths. Another step1810 comprises disposing an intraluminal medical device on a portion ofthe cannula that is free of the pattern of openings. Another step 1812comprises inserting the cannula into an elongate tubular member defininga lumen such that the intraluminal medical device is circumferentiallydisposed about the cannula and within the lumen.

While the examples described above reference specific features ofparticular drawings, it is understood that the various elements and/orfeatures described herein in connection with one particular embodimentcan be combined with those of another without departing from the scopeof the invention. Furthermore, the cannulae, delivery systems andmethods described and illustrated herein are examples. As such, they arenot intended to limit the scope of protection sought in any manner.Rather, they serve only to aid those skilled in the art to makeapparatuses and to practice methods in accordance with the invention.

We claim:
 1. A delivery system, comprising: an outer tubular memberdefining an outer tubular member lumen; a cannula disposed within theouter tubular member lumen, the cannula comprising: an elongate tubularmember having a lengthwise axis and a circumferential wall extendingbetween a proximal end and a distal end and defining an interior lumen;the elongate tubular member having an intermediate axial portionextending between a proximal axial portion that includes the proximalend and a distal axial portion that includes the distal end, the distalaxial portion extending from the distal end toward the proximal end; apattern of openings in the circumferential wall of the elongate tubularmember, the pattern of openings comprising a plurality of openingsarranged in an interrupted spiral that extends circumferentially alongthe intermediate axial portion of the elongate tubular member; whereinthe distal axial portion is free of the pattern of openings andcomprises an uninterrupted circumferential wall; and wherein theproximal axial portion is longer than the distal axial portion; anintraluminal medical device circumferentially disposed around the distalaxial portion of the elongate tubular member and within the lumen of theouter tubular member, the intraluminal medical device having anintraluminal medical device proximal end and an intraluminal medicaldevice distal end; and a pusher slidably disposed over the cannula andwithin the outer tubular member lumen, the pusher having a pusherproximal end and a pusher distal end, the pusher distal end disposedbetween the pusher proximal end and the intraluminal medical deviceproximal end.
 2. The delivery system of claim 1, wherein the pusherdistal end abuts the intraluminal medical device proximal end.
 3. Thedelivery system of claim 1, wherein the pusher comprises a tubularmember.
 4. The delivery system of claim 1, wherein the proximal axialportion of the elongate tubular member is free of the pattern ofopenings and comprises an uninterrupted circumferential wall.
 5. Thedelivery system of claim 1, further comprising a conical distal tipsecured to the distal end of the elongate tubular member.
 6. Thedelivery system of claim 1, further comprising a double-tapered distaltip secured to the distal end of the elongate tubular member; whereinthe double-tapered distal tip has an outer diameter that is greater thanan outer diameter of the elongate tubular member.
 7. The delivery systemof claim 1, wherein the elongate tubular member comprises a metal. 8.The delivery system of claim 7, wherein the metal comprises stainlesssteel.
 9. The delivery system of claim 1, wherein the intraluminalmedical device comprises a self-expandable medical device.
 10. Thedelivery system of claim 9, wherein the intraluminal medical devicecomprises a stent.
 11. The delivery system of claim 9, wherein theintraluminal medical device comprises a valve.
 12. The delivery systemof claim 1, wherein each opening of the plurality of openings comprisesan elongate slit that extends through the circumferential wall of theelongate tubular member.
 13. A delivery system, comprising: an outertubular member defining an outer tubular member lumen; a cannuladisposed within the outer tubular member lumen, the cannula comprising:an elongate tubular member having a lengthwise axis and acircumferential wall extending between a proximal end and a distal endand defining an interior lumen; the elongate tubular member having anintermediate axial portion extending between a proximal axial portionthat includes the proximal end and a distal axial portion that includesthe distal end, the distal axial portion extending from the distal endtoward the proximal end; and a pattern of openings in thecircumferential wall of the elongate tubular member, the pattern ofopenings comprising a plurality of openings arranged in an interruptedspiral that extends circumferentially along the intermediate axialportion of the elongate tubular member; wherein the proximal axialportion and the distal axial portion are free of the pattern of openingsand comprise an uninterrupted circumferential wall; and wherein theproximal axial portion is longer than the distal axial portion; aself-expandable intraluminal medical device circumferentially disposedaround the distal axial portion of the elongate tubular member andwithin the lumen of the outer tubular member, the intraluminal medicaldevice having an intraluminal medical device proximal end and anintraluminal medical device distal end; and a tubular pusher slidablydisposed over the cannula and within the outer tubular member lumen, thetubular pusher having a pusher distal end that abuts the intraluminalmedical device proximal end.
 14. The delivery system of claim 13,wherein the intraluminal medical device comprises a stent.
 15. Thedelivery system of claim 13, wherein the intraluminal medical devicecomprises a valve.
 16. The delivery system of claim 13, wherein eachopening of the plurality of openings comprises an elongate slit thatextends through the circumferential wall of the elongate tubular member.17. A delivery system, comprising: an outer tubular member defining anouter tubular member lumen; a cannula disposed within the outer tubularmember lumen, the cannula comprising: an elongate tubular member havinga lengthwise axis and a circumferential wall extending between aproximal end and a distal end and defining an interior lumen; theelongate tubular member having an intermediate axial portion extendingbetween a proximal axial portion that includes the proximal end and adistal axial portion that includes the distal end, the distal axialportion extending from the distal end toward the proximal end; a patternof openings in the circumferential wall of the elongate tubular member,the pattern of openings comprising a plurality of openings arranged inan interrupted spiral that extends circumferentially along theintermediate axial portion of the elongate tubular member; and adouble-tapered distal tip secured to the distal end of the elongatetubular member, the double-tapered distal tip having an outer diameterthat is greater than an outer diameter of the elongate tubular member;wherein the proximal axial portion and the distal axial portion are freeof the pattern of openings and comprise an uninterrupted circumferentialwall; and wherein the proximal axial portion is longer than the distalaxial portion; a self-expandable intraluminal medical devicecircumferentially disposed around the distal axial portion of theelongate tubular member and within the lumen of the outer tubularmember, the intraluminal medical device having an intraluminal medicaldevice proximal end and an intraluminal medical device distal end; and atubular pusher slidably disposed over the cannula and within the outertubular member lumen, the tubular pusher having a pusher distal end thatabuts the intraluminal medical device proximal end.
 18. The deliverysystem of claim 17, wherein each opening of the plurality of openingscomprises an elongate slit that extends through the circumferential wallof the elongate tubular member.
 19. The delivery system of claim 17,wherein the intraluminal medical device comprises a stent.
 20. Thedelivery system of claim 17, wherein the intraluminal medical devicecomprises a valve.